| NPI | 1518974476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN A WORCESTER Director 813-382-2056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-03-1200) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 4942) |
| 103TS0200X Psychologist, School (Licence: FL SS 974) | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-07-02 |